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Bio-Indentical Hormone Introduction

I have consolidated some useful information in an effort to help you better understand what bio-identical hormone replacement therapy is about. While bio-identical hormones have been known since the 1930s, there have been technologic and regulatory issues which have kept time released pellet insertion therapy from being available in the US until the 1990’s - despite general agreement that bio-identical hormone replacement was far better than non-human hormones. Some of the reasons for this are touched upon below. Technology now exists that allows us the opportunity to have “time release” pellets of certain human hormones placed under our skin to restore more youthful hormone levels directly into the bloodstream. While I do not believe this therapy is a “fountain of youth”, I am extremely confident that it can dramatically improve many people’s quality of life and health in measurable ways. It is vitally important that you continue to see your regular medical doctor for your usual health care, tests, and routine health maintenance. I am not replacing your doctor. I encourage you to use the new found energy restored hormone levels give you to exercise and eat well.

 

What exactly are hormones?

Hormones are chemical messengers secreted into blood or body fluids by one type of cell that affect the functioning of other cells. Most hormones circulate in blood, coming into contact with essentially all your body’s cells. However, a specific hormone usually affects only specific cells called target cells. A target cell responds to a hormone because it has receptors for that particular hormone. Cells which do not have such a receptor cannot be influenced directly by that hormone.

What is meant by bio-identical?

Bio-identical hormones have the exact same chemical structure as hormones that are made by the human body. The difference between natural (or bio-identical) versus synthetic is in the molecular structure of the hormone. In order for a replacement hormone to fully replicate the function of hormones that we originally produced, the chemical structure must exactly match the original. Structural differences that exist between human (bio-identical) and non bio-identical hormones are very likely responsible for side effects and health risks experienced and written about when non bio-identical hormones are used in humans.

Why are humans taking non bio-identical hormones?

In brief… “corporate greed and profit”. The FDA declared that since bio-identical hormones are considered to be natural regardless of their source, they cannot be patented. Therefore, large drug companies cannot significantly profit off the use and sale of bio-identical hormones. The pharmaceutical industry’s hormones are mainly produced by changing the molecular structure of a non-human hormone (horse hormones collected from pregnant mare urine) to create products that can be patented by the manufacturer. Mass production of these non-human type hormones by drug companies is very profitable despite the serious health issues and side effects thought to be caused by them. Conversely, bio-identical hormones (which have not been shown to have any serious side effects) have not had powerful advocates until recently. With two Oprah Shows in January of 2009 discussing the importance of bio-identical hormones, I expect there to be much future research money directed at exploring their benefits. The bio-identical hormones potential quality of life and health benefits are huge for those with deficiencies include those from aging.

What is bio-identical hormone therapy?

The goal of Bio-identical Hormone replacement therapy is to provide an adequate supply of the deficient hormone(s) in a form that is molecularly identical to that which the body originally produced. Logically this results in the hormone’s normal physiologic effects being restored. Every person is unique. Therefore, it is sensible for you and I to work together to customize a hormone replacement therapy based on blood levels and symptom relief. The precise components of each person's therapy are determined after consultation and evaluation of laboratory testing. Lab studies are done on a blood sample to assess the hormone levels.

How is the Bio-identical hormone therapy administered in my practice?

Bio-identical hormones are available in various strengths from a highly rated commercially licensed manufacturing pharmacy. The hormones are derived from an ingredient found in Yams and Soy beans. (My pellets are Yam based.) For Estradiol (a human estrogen) and Testosterone (a male and female hormone), the hormones are administered via pellets inserted under the skin. They are extremely small (e.g. the estradiol pellet is smaller than a grain of rice), and can provide a steady hormone level for months. Some women will also require bio-identical progesterone which is a pill taken at bedtime. Bio-identical Estradiol and Testosterone are not suitable for oral ingestion as they get chemically changed during the intestinal absorption process.

Goals of bio-identical hormone replacement therapy include:

• Alleviation of the symptoms caused by the natural decrease in production of hormones by the body.
• Re-establishing the protective benefits which were originally provided by naturally occurring hormones.
• Decreasing the diseases of aging such as cardiovascular disease, dementia and osteoporosis.
• Improving the quality of life long-term.

There are several hormones that decrease with aging including:

Estrogen

Estrogen refers to a group of similar hormones produced in the body. The main three are estrone (E1), estradiol (E2), and estriol (E3). Estradiol is produced mainly by the ovaries. Estrone is produced by the adrenal glands and fat cells, and, when menopause occurs, it becomes the most prevalent estrogen. Estriol is produced in large quantities in pregnancy and is also the main circulating estrogen in young women. Estriol is produced in the body from estrone and estradiol. Estrogen protects against heart disease, stroke, osteoporosis, Alzheimer's disease and memory disorders. It protects against vaginal atrophy, urinary incontinence, and prevents symptoms of menopause, including hot flashes and temperature dis-regulation. It improves balance by improving the “visual somatosensory” system in the central nervous system. Estrogen deficiency results in: urogenital atrophy, incontinence, sagging skin in the breasts, increased skin wrinkles of the face, fatigue, depression, mood swings and decreased libido. It is of extreme importance that the estrogen prescribed be a natural estrogen and not a synthetic estrogen. The synthetic estrogens have been shown to be harmful. For optimal health, we believe bio-identical estrogen supplementation should be balanced by bio-identical progesterone supplementation.

Progesterone

Progesterone is primarily produced in the ovary just prior to and after ovulation. It is also produced in large quantities by the placenta during pregnancy and in small quantities by the adrenal glands. Progesterone reduces symptoms of premenstrual syndrome. It seems to protect against uterine and breast cancers, osteoporosis, fibrocystic disease and ovarian cysts. It dramatically decreases menopausal symptoms. Unfortunately, most U.S. women are prescribed synthetic progestins (Provera) which cause such side effects as bloating, headaches, fatigue and weight gain. The bio-identical progesterone does not have these side effects.

Testosterone

Testosterone in men is mainly produced by the testicles and in smaller quantities by the adrenal glands. In women, testosterone is produced in both the ovaries and the adrenal glands. Testosterone contributes to muscle mass, strength and endurance, decreased fat, increased exercise tolerance, enhancement of the sense of well-being and psychological health. Testosterone protects against cardiovascular disease, hypertension, body fat and arthritis. It leads to improved lean muscle mass, increased bone density, decrease in cholesterol, improved skin tone, improved healing capacity, and increased libido and sexual performance. It prolongs the quality of life by decreasing the diseases of aging, as does estrogen in the female. Testosterone is present and extremely important in the female as well as the male, making supplementation important for both men and women.

DHEA

DHEA is a hormone secreted by the adrenal glands. This hormone is a precursor to the other sex hormones. In addition to having its own hormone effect, it results in a shift to an anabolic or protein building state. It reduces cardiovascular risk by increasing lipolysis, the breakdown of fat. It also stimulates the immune system, restores sexual vitality, improves mood, decreases cholesterol and body fat. Recent studies point to DHEA as an anti-stress hormone, reversing the effects of stress on the immune system. I may suggest this as an additional oral supplement to you, depending on your levels and goals.

What is involved in starting Bio-identical Hormone therapy?

You will fill out a medical history and symptoms questionnaire, discuss your symptoms with us and get a form for your blood test. Several days later you will meet with me to discuss the results of the tests and your appropriateness for this therapy. If you decide to proceed, it take less than 10 minutes to insert the pellets. You can resume normal activities (except for swimming and strenuous exercise which require a 4 day wait). In 3 weeks for women and 4 weeks for men, another blood test will be done and most of you will come in to have a “booster” pellet insertion done. In your first year of treatment expect to have 3 or 4 insertions. After 6 months, the hormone levels stabilize and you can anticipate twice a year insertions. You can stop at anytime and your levels will drift back to your pre-treatment levels – with accompanying symptoms. There is no age limit on treatment. Patients as young a 21 (particularly PCOS patients) and up to men and women in their 80s have had wonderful benefits from this therapy.

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